妊娠相关血浆蛋白-A对急诊胸痛患者诊断急性冠状动脉综合征价值的荟萃分析

A meta-analysis of the value of pregnancy-associated plasma protein-A in diagnosis of acute coronary syndrome for patients with chest pain

目的分析妊娠相关血浆蛋白-A(PAPP-A)对急诊胸痛患者急性冠状动脉综合征(ACS)的诊断意义。方法检索从2000年至2017年5月所有PUBMED,Embase及Cochrane Library数据库的文献,检索关键词:PAPP-A,仅限于英文文献。根据纳入排除标准,共6个研究(包括2081例参与者和528个事件)纳入荟萃分析,使用固定、随机效应模型提取比值比(OR)及95%可信区间(CI)以及曲线下面积(AUC)。采用敏感性分析探讨异质性来源。结果 PAPP-A水平升高组对ACS的诊断意义明显高于低水平组[OR:3.10(95%CI:2.08~4.60,P=0.000),AUC:0.60(95%CI:0.57~0.63,P=0.001)。结论 PAPP-A水平的升高有助于急诊胸痛患者ACS的诊断。

Objective To evaluate the pregnancy-associated plasma protein-A（ PAPP-A）in diagnosis of acute coronary syndrome（ ACS） for patients with acute chest pain in emergency room.Methods We retrieved literatures from June 2000 to May 2017 all PUBMED,Embase and Cochrane Library database,with search keyword PAPP-A and limited to the English literature. A total of 6 studies were enrolled,including 2 081 participants and 528 events based on inclusion and exclusion criteria. Random or fixed effect models were used to extract odds ratio（ ORs） and their 95% confidence intervals（ CIs）.Sensitivity analysis was performed to explore the potential sources of heterogeneity. Results Elevated serum PAPP-A was associated with the risk of ACS ： OR： 3. 01（ 95% CI： 2. 08-4. 60,P = 0. 000）,AUC：0. 60（ 95% CI： 0. 57 ~ 0. 63,P = 0. 001）. Conclusions Elevated serum PAPP-A is helpful for diagnosis of ACS in patients with acute chest pain in emergency room.